<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Strict//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-strict.dtd">
<html xmlns="http://www.w3.org/1999/xhtml"
      xmlns:h="http://java.sun.com/jsf/html"
      xmlns:f="http://java.sun.com/jsf/core"
      xmlns:c="http://java.sun.com/jsp/jstl/core">
    <f:view>
        <head>
            <meta http-equiv="Content-Type" content="text/html; charset=UTF-8"/>
            <title>Ingreso de Rips</title>

            <script type="text/javascript" src="../common/js/rips.js"></script>

            <script type="text/javascript" src="../common/js/jquery.timeentry.js"></script>
            <link type="text/css" href="../common/css/jquery.timeentry.css" rel="stylesheet" />
            <script type="text/javascript" src="../common/js/jquery.validate.js"></script>

            <style>
                #tab_estancia { height: 370px; }
                .tabs-bottom { position: relative; }
                .tabs-bottom .ui-tabs-panel { height: 320px; overflow: auto; }
                .tabs-bottom .ui-tabs-nav { position: absolute !important; left: 0; bottom: 0; right:0; padding: 0 0.2em 0.2em 0; }
                .tabs-bottom .ui-tabs-nav li { margin-top: -2px !important; margin-bottom: 1px !important; border-top: none; border-bottom-width: 1px; }
                .ui-tabs-selected { margin-top: -3px !important; }
            </style>



        </head>
        <body>


            <div style="width: 100%; text-align: center;">



                <table width="100%">
                    <tr class="ui-widget-header">
                        <td>
                            Factura
                        </td>                                   
                        <td>
                            Prestador
                        </td>                                    
                        <td>
                            Eps
                        </td>

                    </tr>
                    <tr>                                    
                        <td>                                        
                            <input size="10" type="text" id="fac_rip" />
                        </td>
                        <td>
                            <input size="25" type="text" id="prestador_rip" />
                        </td>
                        <td>
                            <input size="25" type="text" id="eps_rip"/>
                        </td>
                        <!--
                        <td>
                            <input size="10" type="text" id="cto_rip"/>
                        </td>                                    
                        -->
                    </tr>

                </table>


                <table width="100%">
                    <tr class="ui-widget-header">
                        <td>
                            Identificaci&oacute;n
                        </td>                                   
                        <td>
                            Nombre Completo
                        </td>                                    
                        <td>
                            Sexo
                        </td>
                        <td>
                            Edad
                        </td>

                    </tr>
                    <tr>
                        <td>
                            <input size="10" type="text" id="identificacion_rip" />
                        </td>
                        <td>
                            <input size="25" type="text" id="nombre_rip" />
                        </td>
                        <td>
                            <input size="15" type="text" id="sexo_rip"/>
                        </td>
                        <td>
                            <input size="5" type="text" id="edad_rip"/>
                        </td>
                        <!--
                         <td>
                             <input size="10" type="text" id="regimen_rip"/>
                         </td>
                        -->
                    </tr>

                </table>                


                <div id="adicional-rips">
                    <input type="hidden" id="tiene_estancia" name="tiene_estancia"/>
                    <input type="hidden" id="tiene_rn" name="tiene_rn"/>
                    <input type="text" id="idfactura_rips" name="idfactura_rips"/>
                    <input type="hidden" id="idpaciente" name="idpaciente" value="0" />
                    <input type="hidden" id="numero_factura" name="numero_factura" value="0" />
                    <input type="hidden" id="codigo_prestador" name="codigo_prestador" value="0" />
                </div>


                <div id="lista-actividades-rips"></div>



                <div id="acord_rips">
                    <h3><a href="#">Consultas</a></h3>
                    <div>
                        <div id="lista-consultas" style="height: 180px">

                        </div>
                    </div>
                    <h3><a href="#">Procedimientos</a></h3>
                    <div>
                        <div id="lista-procedimientos">                        
                        </div>
                    </div>
                    <h3><a href="#">Otros Servicios</a></h3>
                    <div>
                        <div id="lista-otros"></div>
                    </div>
                </div>
                <br />

                <button style="display: none" onclick="" id="ripEst">Ingresar Estancia</button>

            </div>


            <!--dialogo rips CN-->
            <div id="dialogoIngresoRips" style="display: none" title="Ingreso RIPS">
                <form id="rips-cn">
                    <input type="hidden" id="iddetallecn" name="iddetallecn" value="0" />                   
                    <input type="hidden" id="valorcn" name="valorcn" value="0" />
                    <input type="hidden" id="valorcopagocn" name="valorcopagocn" value="0" />
                    <input type="hidden" id="valortotalcn" name="valortotalcn" value="0" />
                    <input type="hidden" id="band_rips" name="band_rips" value="0" />
                    <!--<input type="text" id="idfactura_ac" name="idfactura_ac"/>-->
                    <!-- <input type="hidden" id="cod_actividad" name="cod_actividad" value="0" />-->
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>C&oacute;digo</td>
                            <td>Descripci&oacute;n</td>
                        </tr>
                        <tr>
                            <td>
                                <input size="11" type="text" id="codactripcn" name="codactripcn" readonly="true"/>
                            </td>

                            <td>
                                <input size="57" type="text" id="desactripcn" readonly="true"/>
                            </td>
                        </tr>
                    </table>

                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Fecha</td>
                            <td>Autorizacion</td>
                        </tr>
                        <tr>
                            <td>
                                <input size="11" type="text" id="fecharipcn" name="fecharipcn" value="0" readonly="true"/>
                            </td>

                            <td>
                                <input size="57" type="text" id="ordenripcn" name="ordenripcn" value="0" />
                            </td>
                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Finalidad</td>
                            <td>Causa Externa</td>
                            <td>Tipo Diagn&oacute;stico</td>
                        </tr>
                        <tr>
                            <td>
                                <select style="width: 250px" class="text ui-widget-content" id="finalidadcn" name="finalidadcn" value=""></select>
                            </td>

                            <td>
                                <select style="width: 250px" class="text ui-widget-content" id="causaexcn" name="causaexcn" value=""></select>
                            </td>

                            <td>
                                <select class="text ui-widget-content" id="tipodxcn" name="tipodxcn"></select>
                            </td>

                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Diagn&oacute;stico</td>
                            <!--<td>Tipo Diagn&oacute;stico</td>-->
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxpalcn" id="id_dxpalcn" value="" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,1);" onblur="fill1();" size="72" type="text" id="dxpalcn" ondblclick="this.value='';$('#id_dxpalcn').val('')" />
                                <div class="suggestionsBox" id="sug_dxpalcn" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxpalcnList">
                                        &nbsp;
                                    </div>
                                </div>

                            </td>
                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Diagn&oacute;stico Relacionado 1</td>
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxcn1" id="id_dxcn1" value="0" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,2);" onblur="fill2();"  size="72" type="text" id="dxcn1"  ondblclick="this.value='';$('#id_dxcn1').val('0')"/>
                                <div class="suggestionsBox" id="sug_dxcn1" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxcn1List">
                                        &nbsp;
                                    </div>
                                </div>
                            </td>
                        </tr>
                        <tr class="ui-widget-header">
                            <td>Diagn&oacute;stico Relacionado 2</td>
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxcn2" id="id_dxcn2" value="0" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,3);" onblur="fill3();"  size="72" type="text" id="dxcn2"  ondblclick="this.value='';$('#id_dxcn2').val('0')"/>
                                <div class="suggestionsBox" id="sug_dxcn2" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxcn2List">
                                        &nbsp;
                                    </div>
                                </div>
                            </td>
                        </tr>
                        <tr class="ui-widget-header">
                            <td>Diagn&oacute;stico Relacionado 3</td>
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxcn3" id="id_dxcn3" value="0" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,4);" onblur="fill4();"  size="72" type="text" id="dxcn3"  ondblclick="this.value='';$('#id_dxcn3').val('0')"/>
                                <div class="suggestionsBox" id="sug_dxcn3" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxcn3List">
                                        &nbsp;
                                    </div>
                                </div>
                            </td>
                        </tr>

                    </table>
                </form>
            </div><!--fin rips cn-->


            <!--dialogo rips AP-->
            <div id="dialogoIngresoRipsAp" style="display: none" title="Ingreso RIPS">

                <form id="rips-ap">

                    <input type="hidden" id="iddetalleap" name="iddetalleap" value="0"/>
                    <input type="hidden" id="valorap" name="valorap" value="0"/>
                    <input type="hidden" id="band_ripsap" name="band_ripsap" value="0" />

                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>C&oacute;digo</td>
                            <td>Descripci&oacute;n</td>
                        </tr>
                        <tr>
                            <td>
                                <input size="20" type="text" id="codactripap" name="codactripap" readonly="true"/>
                            </td>

                            <td>
                                <input size="50" type="text" id="desactripap"  readonly="true"/>
                            </td>
                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Fecha</td>
                            <td>Autorizacion</td>
                        </tr>
                        <tr>
                            <td>
                                <input size="20" type="text" id="fecharipap" name="fecharipap"  readonly="true"/>
                            </td>

                            <td>
                                <input size="50" type="text" id="ordenripap" name="ordenripap" value="0" />
                            </td>
                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Finalidad</td>
                            <td>Ambito Procedimiento</td>
                        </tr>
                        <tr>
                            <td>
                                <select class="text ui-widget-content" id="finalidadap" name="finalidadap" value="0"></select>
                            </td>

                            <td>
                                <select class="text ui-widget-content" id="ambitoap" name="ambitoap" value="0"></select>
                            </td>
                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Diagn&oacute;stico</td>
                            <td>Personal Atiende</td>
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxpalap" id="id_dxpalap" value="0" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,5);" onblur="fill5();" size="50" type="text" id="dxpalap" ondblclick="this.value='';$('#id_dxpalap').val('')" />
                                <div class="suggestionsBox" id="sug_dxpalap" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxpalapList">
                                        &nbsp;
                                    </div>
                                </div>

                            </td>

                            <td>
                                <select class="text ui-widget-content" id="personalatiendeap" name="personalatiendeap"></select>
                            </td>
                        </tr>
                    </table>
                    <table width="100%">
                        <tr class="ui-widget-header">
                            <td>Diagn&oacute;stico Relacionado</td>
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxap1" id="id_dxap1" value="0" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,6);" onblur="fill6();"  size="70" type="text" id="dxap1"  ondblclick="this.value='';$('#id_dxap1').val('0')"/>
                                <div class="suggestionsBox" id="sug_dxap1" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxap1List">
                                        &nbsp;
                                    </div>
                                </div>
                            </td>
                        </tr>
                        <tr class="ui-widget-header">
                            <td>Complicaci&oacute;n</td>
                        </tr>
                        <tr>
                            <td>
                                <input type="hidden" size="30" name="id_dxapcom" id="id_dxapcom" value="0" class="ui-widget-content" />
                                <input onkeyup="lookup(this.value,7);" onblur="fill7();"  size="70" type="text" id="dxapcom"  ondblclick="this.value='';$('#id_dxapcom').val('0')"/>
                                <div class="suggestionsBox" id="sug_dxapcom" style="display: none;">
                                    <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                    <div class="suggestionList" id="sug_dxapcomList">
                                        &nbsp;
                                    </div>
                                </div>
                            </td>
                        </tr>
                        <tr class="ui-widget-header">
                            <td>Forma Acto Quirurgico</td>
                        </tr>
                        <tr>
                            <td>
                                <select class="text ui-widget-content" id="formaqxap" name="formaqxap" value="0"></select>
                            </td>
                        </tr>

                    </table>
                </form>
            </div><!--fin rips AP-->


            <!--dialogo rips ESTANCIA-->
            <div id="dialogoRegistroEstancia" style="display: none" title="Registrar Estancia">

                <div id="tab_estancia" class="tabs-bottom">
                    <ul>
                        <li><a href="#tab_estancia-1">Ingreso</a></li>
                        <li><a href="#tab_estancia-2">Salida</a></li>
                        <li><a href="#tab_estancia-3">Registrar Reci&eacute;n Nacidos</a></li>
                    </ul>

                    <form id="rips-estancia">

                        <div id="tab_estancia-1">
                            <table width="60%">
                                <tr class="ui-widget-header">
                                    <td colspan="2">Fecha / Hora Ingreso</td>                                    
                                </tr>
                                <tr>
                                    <td>
                                        <input size="12" type="text" id="fecin" name="fecin"/>                                        
                                    </td>
                                    <td>
                                        <input size="10" type="text" id="horain" name="horain"/>
                                    </td>
                                </tr>
                            </table>

                            <table width="100%">
                                <tr class="ui-widget-header">
                                    <td>Ingresado por</td>
                                    <td>Diagn&oacute;stico Ingreso</td>
                                </tr>
                                <tr>
                                    <td>
                                        <select style="width: 200px" class="text ui-widget-content" id="viaingreso" name="viaingreso" value="0"></select>
                                    </td>

                                    <td>
                                        <input type="hidden" size="30" name="id_dxin" id="id_dxin" value="0" class="ui-widget-content" />
                                        <input onkeyup="lookup(this.value,8);" onblur="fill8();"  size="40" type="text" id="dxin" />
                                        <div class="suggestionsBox" id="sug_dxin" style="display: none;">
                                            <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                            <div class="suggestionList" id="sug_dxinList">
                                                &nbsp;
                                            </div>
                                        </div>
                                    </td>
                                </tr>
                            </table>
                            <table width="100%">
                                <tr class="ui-widget-header">
                                    <td>Causa Externa</td>
                                    <td>Nro Cama</td>
                                </tr>
                                <tr>
                                    <td>
                                        <select style="width: 200px" class="text ui-widget-content" id="causaexin" name="causaexin" ></select>
                                    </td>

                                    <td>
                                        <input size="20" type="text" id="cama" name="cama"/>
                                    </td>
                                </tr>
                            </table>

                            <table width="100%">
                                <tr class="ui-widget-header">
                                    <td>Estado Ingreso</td>
                                    <td>Autorizaci&oacute;n</td>                                    
                                </tr>
                                <tr>
                                    <td>
                                        <select style="width: 200px" class="text ui-widget-content" id="estadoin" name="estadoin" ></select>

                                    </td>

                                    <td>
                                        <input size="20" type="text" id="ordenripest" name="ordenripest"/>
                                    </td>
                                </tr>
                            </table>
                        </div>
                        <div id="tab_estancia-2">
                            <table >
                                <tr class="ui-widget-header">
                                    <td colspan="2">Fecha / Hora Salida</td>

                                </tr>
                                <tr>
                                    <td>
                                        <input size="12" type="text" id="fecsal" name="fecsal"/>                                        
                                    </td>

                                    <td>
                                        <input size="10" type="text" id="horasal" name="horasal"/>
                                    </td>
                                </tr>
                            </table>

                            <table width="100%">
                                <tr class="ui-widget-header">
                                    <td>Estado Salida</td>
                                    <td>Diagn&oacute;stico Salida</td>
                                </tr>
                                <tr>
                                    <td>
                                        <select style="width: 200px" class="text ui-widget-content" id="estadosal" name="estadosal" ></select>

                                    </td>

                                    <td>
                                        <input type="hidden" size="30" name="id_dxsal" id="id_dxsal" value="" class="ui-widget-content" />
                                        <input onkeyup="lookup(this.value,9);" onblur="fill9();"  size="40" type="text" id="dxsal" />
                                        <div class="suggestionsBox" id="sug_dxsal" style="display: none;">
                                            <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                            <div class="suggestionList" id="sug_dxsalList">
                                                &nbsp;
                                            </div>
                                        </div>
                                    </td>
                                </tr>
                            </table>

                            <table >
                                <tr class="ui-widget-header">
                                    <td colspan="2">Destino Salida</td>

                                </tr>
                                <tr>
                                    <td>
                                        <select style="width: 200px" class="text ui-widget-content" id="destinosal" name="destinosal" ></select>
                                    </td>

                                    <td>
                                        &nbsp;
                                    </td>
                                </tr>
                            </table>



                            <table width="100%">
                                <tr class="ui-widget-header">
                                    <td>Diagn&oacute;stico Relacionado 1</td>
                                </tr>
                                <tr>
                                    <td>
                                        <input type="hidden" size="30" name="id_dxest1" id="id_dxest1" value="0" class="ui-widget-content" />
                                        <input onkeyup="lookup(this.value,10);" onblur="fill10();"  size="70" type="text" id="dxest1" />
                                        <div class="suggestionsBox" id="sug_dxest1" style="display: none;">
                                            <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                            <div class="suggestionList" id="sug_dxest1List">
                                                &nbsp;
                                            </div>
                                        </div>
                                    </td>
                                </tr>
                                <tr class="ui-widget-header">
                                    <td>Diagn&oacute;stico Relacionado 2</td>
                                </tr>
                                <tr>
                                    <td>
                                        <input type="hidden" size="30" name="id_dxest2" id="id_dxest2" value="0" class="ui-widget-content" />
                                        <input onkeyup="lookup(this.value,11);" onblur="fill11();"  size="70" type="text" id="dxest2" />
                                        <div class="suggestionsBox" id="sug_dxest2" style="display: none;">
                                            <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                            <div class="suggestionList" id="sug_dxest2List">
                                                &nbsp;
                                            </div>
                                        </div>
                                    </td>
                                </tr>
                                <tr class="ui-widget-header">
                                    <td>Diagn&oacute;stico Relacionado 3</td>
                                </tr>
                                <tr>
                                    <td>
                                        <input type="hidden" size="30" name="id_dxest3" id="id_dxest3" value="0" class="ui-widget-content" />
                                        <input onkeyup="lookup(this.value,12);" onblur="fill12();"  size="70" type="text" id="dxest3" />
                                        <div class="suggestionsBox" id="sug_dxest3" style="display: none;">
                                            <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                            <div class="suggestionList" id="sug_dxest3List">
                                                &nbsp;
                                            </div>
                                        </div>
                                    </td>
                                </tr>

                                <tr class="ui-widget-header">
                                    <td>Diagn&oacute;stico de Muerte</td>
                                </tr>
                                <tr>
                                    <td>
                                        <input type="hidden" size="30" name="id_dxestm" id="id_dxestm" value="0" class="ui-widget-content" />
                                        <input onkeyup="lookup(this.value,13);" onblur="fill13();"  size="70" type="text" id="dxestm" />
                                        <div class="suggestionsBox" id="sug_dxestm" style="display: none;">
                                            <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                            <div class="suggestionList" id="sug_dxestmList">
                                                &nbsp;
                                            </div>
                                        </div>
                                    </td>
                                </tr>

                            </table>




                        </div>
                    </form>


                    <div id="tab_estancia-3">

                        <button style="display: block" id="nuevorn">Ingresar Reci&eacute;n nacido</button>
                        <table>
                            <tr>
                                <td><button style="display: none" id="guardarrn">Guardar</button></td>
                                <td><button style="display: none" id="cancelarrn">Cancelar</button></td>
                            </tr>
                        </table>



                        <div id="dialogoIngresoRn" style="display: none">

                            <form id="form-recien-nacido">
                                <table >
                                    <tr class="ui-widget-header">
                                        <td>Nombre Completo</td>
                                        <td colspan="3">
                                            <input size="50" type="text" id="nomrn" name="nomrn"/>
                                        </td>
                                    </tr>
                                    <tr class="ui-widget-header">
                                        <td width="150px">Fecha Nacimiento</td>
                                        <td>
                                            <input size="12" type="text" id="fecrn" name="fecrn" value=""/>
                                        </td>
                                        <td width="150px">Hora Nacimiento</td>
                                        <td>
                                            <input size="10" type="text" id="horanac" name="horanac" value=""/>
                                        </td>
                                    </tr>

                                    <tr class="ui-widget-header">
                                        <td width="150px">Edad Gestacional</td>
                                        <td>
                                            <input type="text" size="2" id="edadges" name="edadges" value=""/>
                                        </td>
                                        <td width="150px">Control Prenatal</td>
                                        <td>
                                            <select id="controlpre" name="controlpre" class="text ui-widget-content">
                                                <option value="1">SI</option>
                                                <option value="2">NO</option>
                                            </select>
                                        </td>
                                    </tr>

                                    <tr class="ui-widget-header">
                                        <td width="150px">Sexo</td>
                                        <td>
                                            <select id="idsexo" name="idsexo" class="text ui-widget-content">
                                                <option value="1">MASCULINO</option>
                                                <option value="2">FEMENINO</option>
                                                <option selected="true" value="3">APLICA AMBOS</option>
                                            </select>
                                        </td>
                                        <td width="150px">Peso</td>
                                        <td>
                                            <input type="text" size="4" id="peso" name="peso" value=""/>
                                        </td>
                                    </tr>
                                </table>
                                <table>

                                    <tr class="ui-widget-header">
                                        <td width="150px">
                                            Diagn&oacute;stico RN
                                        </td>
                                        <td>
                                            <input type="hidden" size="30" name="id_dxnac" id="id_dxnac" value="" class="ui-widget-content" />
                                            <input onkeyup="lookup(this.value,14);" onblur="fill14();"  size="50" type="text" id="dxnac" value="" />
                                            <div class="suggestionsBox" id="sug_dxnac" style="display: none;">
                                                <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                                <div class="suggestionList" id="sug_dxnacList">
                                                    &nbsp;
                                                </div>
                                            </div>
                                        </td>
                                    </tr>

                                    <tr class="ui-widget-header">
                                        <td width="150px">
                                            Diagn&oacute;stico Muerte
                                        </td>
                                        <td>
                                            <input type="hidden" size="30" name="id_dxmu" id="id_dxmu" value="0" class="ui-widget-content" />
                                            <input onkeyup="lookup(this.value,15);" onblur="fill15();"  size="50" type="text" id="dxmu" />
                                            <div class="suggestionsBox" id="sug_dxmu" style="display: none;">
                                                <img src="../../../../../common/util/imag/upArrow.png" style="position: relative; top: -12px; left: 30px;" alt="upArrow" />
                                                <div class="suggestionList" id="sug_dxmuList">
                                                    &nbsp;
                                                </div>
                                            </div>
                                        </td>
                                    </tr>
                                </table>
                                <table width="">
                                    <tr class="ui-widget-header">
                                        <td width="150px">Fecha Muerte</td>
                                        <td>
                                            <input size="12" type="text" id="fecmu" name="fecmu"/>
                                        </td>
                                        <td width="150px">Hora Muerte</td>
                                        <td>
                                            <input size="10" type="text" id="horamu" name="horamu"/>
                                        </td>

                                    </tr>                                
                                </table>
                            </form>


                            <div id="lista-rn"></div>

                        </div><!--fin dialogo rn-->

                    </div>
                </div>
            </div>
        </body>
    </f:view>
</html>
